X is actually pretty good now
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Pakistan also has a population of 240 million, which should somewhat mitigate the problem.
The ashkenazi have a small population but they marry anyone within that population.
The average paki marries their cousin and has at least since the 1200s but likely before that as well. Islam just further entrenched what they were already doing.
In London, a decade ago, pakis made up less than 3% of the pop and over half of the birth defects.
Pakis have the highest rate of consanguinious marriage in the world.